Thursday, March 24, 2016

The truth about the Mormon Mental Health Association

If you have ever contemplated looking for a Mormon therapist, or are interested in mental health as it relates to Mormonism or issues around sex addiction and pornography addiction, this post will be of interest to you. If not, this might not be your thing, and that's cool.

How do I even start this?

People often say that human beings love a scandal, and I'm not sure I disagree.

And, as it turns out, there's a bit of a scandal happening in our own backyard. If it's not a scandal, then it's at least something to be aware of if you are an LDS person who ever seeks out professional help from a therapist.

I don't report on this "scandal" to be sensational. As you'll see, I have very clear and specific reasons to be talking about this, and for attempting to set the record straight about an organization who has chosen a name that affords it credibility and status that, frankly, it doesn't deserve.

Consider this post as warning.



A couple of years ago, I was thrilled to find a new organization called the "Mormon Mental Health Association." I am Mormon, I am a psychotherapist, I love fellow Mormons, and I am deeply committed to helping people find ways to maximize their mental health. It seemed like joining this organization was a natural fit. Plus, as I looked into it, I noticed that this organization had a solid stance against reparative therapy (therapy used to try to "fix" gay people and make them straight, which, turns out, is impossible and serves to really mess people up when it's attempted for reasons you can probably imagine). As someone who was subjected to reparative therapy for many years as a youth and young adult, I was incredibly happy to see a Mormon-based organization that so clearly disavowed this highly problematic therapeutic practice, which is being outlawed in many states because of the way it harms people.

I was one of the very first people to pay money to join this group.

Since then, there have been events that have occurred--from the mildly fishy to downright manipulative and professionally negligent--such that I, for one, am no longer associated with this organization, and I regret giving them a dime.

Things got weird right out the gate.

First, the organizer of the group told me she needed to interview me before I could be "admitted" as a member of this organization. This seemed very odd to me--as a Mormon and a licensed mental health professional, was my credentialing not sufficient evidence of my qualification to be included in a group of Mormons who specialize in mental health? I was disconcerted, but I was also willing to go forward with the interview because I had nothing to hide.

Then, the interview never happened. There was some scheduling difficulty, and then . . . radio silence. I was baffled. I didn't know what to make of this, especially when a dear friend and colleague let me know that she was never asked to do an interview in the first place.

After that I didn't hear from the organization for a really, really long time. When the same colleague would mention receiving messages from MMHA (she and I had both joined right around the same time) I couldn't figure out why I wasn't hearing from them. Eventually, by accident, I discovered the problem. Somehow, instead of sending information to the the email address I had listed in my application, they had begun to send me information to another email address I had created half a decade ago when I started my private practice, and had never really used. To this day, I still don't know how they got this email address. Did they find it in an online search about me? Were they worried about me being a part of this group, and if so, why? As a gay Mormon, was I not "Mormon" enough for the Mormon Mental Health Association? I couldn't figure out what the problem was.

Soon, the real issue became clear. And it shocked me.

Several months ago the head of the organization sent out an email to its members to hold a "vote" on a position policy regarding, of all things, sex addiction.

Now, I am a Certified Sex Addiction Therapist (or CSAT). What this means is that along with helping people with many issues like depression, anxiety, marital discord, and communication, I also spend time helping people who find themselves unable to control compulsive sexual behaviors. These are often people who are deeply religious, people who you wouldn't imagine to have such struggles. They are good, good people. And they are experiencing the horror of not being able to control their behaviors, doing things ranging from hours and hours of pornography use to taking advantage of prostituted women or men on a daily or weekly basis, to exhibitionism to . . . you name it. These are things my clients--who are amazing people--experience in their lives. These behaviors are devastating to my clients. The consequences are real, and the pain these people feel--often interlaced with profound religious shame--is breathtaking. And that's not to mention the betrayal trauma inflicted on spouses when discoveries of these secret compulsive behaviors are uncovered, which is another thing I specialize in. I work hard to help spouses cope with the deep wounds they feel when they have experienced a betrayal, the pain of which I outline in this article.

Therapy with people in these challenging circumstances is incredibly intense, multifaceted and complex. I have paid thousands of dollars and have spent hundreds of hours in trainings and supervision with incredibly gifted clinicians to learn how to appropriately and effectively treat individuals and families that have encountered these problems. And the number of people who experience difficulties with these issues is staggering. This is something that affects many, many Mormons.

I was stunned when I got the email regarding a vote on this issue. Guess what the vote was? It was to exclude sexual addiction from being talked about as a problem amongst Mormons.

Yes. You read that correctly.

They were voting to take a position that sexual addiction is not real, that any behaviors related to sexual compulsivity are the result of religious messages and other mental illness, and that treating sexual behaviors that people can't stop (after years and years of trying) as an addiction is not an acceptable way to help clients. They were making this claim even though there is no peer-reviewed science backing up their conclusions whatsoever.

They were going so far as to not letting clinician use the words "sex addiction" as they describe their specializations and even worse, not letting people like me list the fact that they are officially certified to help with sex addiction in their biographies.

I find this highly negligent.

If I am seeking help with eating disorders, I want someone with experience and training in treating eating disorders. Therapy with someone without that specialty can lead to worsening the problem, not helping it. Likewise, if someone has discovered that they or their partner has dealt with years and years of compulsive, clandestine sexual behaviors that has put their marriage (and sometimes their very lives) in jeopardy, they need to be able to find someone who is trained to help in that very complicated circumstance. CSATs have extensive training and supervision regarding how to treat trauma, how to help marriages where betrayal has happened, and how to heal relationships without worsening the trauma. Couples who see someone without that training are often told very damaging things. Wives who have been betrayed by their husbands are often told that they are the reason their husband is acting out sexually because they are repressed and prudish--when really they are neither of those things. Instead, they are traumatized by the betrayal, as well as by the ways sexual addiction has affected a husband's behavior (both sexually and non-sexually). Not surprisingly, the response to that trauma often includes not feeling comfortable or safe having sex with their husband, the very person who has hurt and betrayed them. These spouses' traumas are then discounted and explained away by theories of religious repression and lack of sex ed. Often, they have been told that told they are the problem by their sex-hungry husband for many years, and this message is then reinforced by the ignorant clinician (or religious leader). This further traumatizes the spouse, often leaving the marriage in a shambles. This is just one example of the deeply complicated, multi-layered complexity of working with people who are confronting a type of betrayal that, because of its addictive nature, happens again and again and again.

Someone without the appropriate training would not be able to make heads or tails of situations as complex as a multi-year marriage interlaced with multiple betrayals and the profound denial-based messaging this dynamic creates in a couple. It is my observation that untrained clinicians often do more damage than good when they try.

Being able to see the designation of "Certified Sex Addiction Therapist" is critical for clients in this vulnerable state.

When I got this email, which included a "survey" for the members of the organization to "vote" on the issue, I was deeply frustrated and very, very concerned. Not only was the fact that this issue was being put to a vote incredibly concerning to me, but the voting itself was profoundly biased. It did not present two sides of the issue and ask a group of professionals to use their discretion and judgment to make a collective choice. Instead, it presented one side of the information very sensationally, cited no research to back its claims (aside from quotes from a few random Master's level clinicians), and gave no primer on the actual issues being discussed. This was how they were deciding an official policy decision!

I suddenly realized that this was the modus operandi of the entire organization--even with the issues I happened to agree with. This was not a scientifically robust community searching out the answers and positions that would best help the Mormon community. It was a very small pocket--perhaps even a pocket of one--of people who wished to project the biases of their own experiences and opinions onto an entire organization, and in turn an entire culture--all while brandishing the name the "Mormon Mental Health Association." More about that later.

I reacted quickly and incisively. I found the email address of every member of the board of the organization and sent them a lengthy message with my concerns. (If you're interested, I've included the email I sent them below.) To summarize, in the letter I point out that the field of process addictions is so young that there is very little robust peer-reviewed science for or against sex addiction, and that to take such a drastic stance against sex addiction with such a paucity of data verges on unethical. (Interestingly, even in the months since sending that letter, I have encountered groundbreaking articles establishing a clear connection between pornography and addiction-based neurological reward centers, like this one or this one. If the MMHA were truly an organization interested in robust scientific inquiry as they claim, they would have already encountered this research, and would not require someone like me to point such articles out.) Additionally, in the letter I pointed out some of the logical fallacies of their conclusions, explained why a position against sex addiction would not be good for Mormons, and then said that if this action went forward, I would no longer be a member of the organization. I also informed them that if they took this step, I would feel professionally obligated to alert people to the highly problematic nature of this decision.

Though I heard through the grape-vine that my email had caused major waves, the formal response was pitiful. A tiny email from the founder of the group which said basically nothing--one or two sentences long. The response was so drastically negligent and non-conversational that I had other members of the board contact me separately apologizing for how wildly inadequate the response I got was.

After sending the email and getting no response, I felt powerless and very concerned. It seemed apparent to me that the action of taking this official position was going to go forward--how could it not, when the system was rigged to get the outcome that fit the leaders' bias?--and I didn't know what to do about it. Part of me wanted to fight. Part of me wanted to rally all the professionals I know who are passionate about helping the issue of sex addiction and push against this. But then, as I thought about it, I wondered if my time would be better spent building something different and more helpful rather than trying to tear something down I disagreed with. I contemplated the idea of doing nothing directly about MMHA and their policy (kind of a "not my circus, not my monkeys..." stance) and instead focus on building resources that would help the vulnerable population I was concerned about. I have many plans in play to accomplish this end. As months passed, I forgot about the situation and was leaning towards not acting.

UNTIL last week when one a dear friend of mine contacted me in a panic. This person texted me asking what my thoughts were about the position she had just read by the Mormon Mental Health Association regarding sex addiction.

Do you see the problem here? Do you see how that question sounds? Do you see how what she saw must have struck her? How it must have felt to read that position coming from a group with that name?

This is a personal friend, whose story I happen to know. I happen to know of her devastation when confronting issues of sexual addiction in her marriage. I happen to have seen her shed tears, and wonder if she should leave her husband (an incredibly good man) because of his dishonesty and his compulsive sexual behaviors. When I received this text from her, wondering how a Mormon Mental Health Association could so blatantly disregard her real-life experience--both the pain she went through for years, as well as the recovery and healing she experienced when she and her husband received treatment from Certified Sex Addiction Therapists--I knew immediately I needed to write this post.

There is a reason my friend texted me within days of this organization posting their official statement. It is because she felt harmed by this position, most especially in the context of the word "Mormon" brandished in this organization's name.

There is a reason the church does not generally allow organizations not affiliated with it to use the word "Mormon" in their title. It is because that term has cultural significance. It is a term that adds credibility when being assessed by populations who have no way of knowing that credibility was earned by nothing more than typing the word "Mormon" into the name itself.

When people hear that "the Mormon Mental Health Association" thinks this or that other thing, they are often, just as my friend did, going to assume that the Mormon church, or an organization endorsed by the Mormon church, thinks that thing.  That is not okay.

And I have to take ownership of my own problematic behavior here: back when it was associated with a cause I believed in (the disavowal of reparative therapy), this incongruous messaging didn't seem so bad. I regret not thinking more deeply about this then. Now that it is affecting me professionally, and affecting people I love, the highly deceptive nature of the branding, the poor messaging, and the biases of this organization sing out loud and clear.

The truth about the Mormon Mental Health Association is that it is neither Mormon, nor particularly concerned with the pursuit of scientifically-based mental health. More so, the organization is a reflection of the cultural biases of its creator and some of its leaders, who appear to hope to make an impact on the trends of Mormon culture by using the word "Mormon" as part of its branding, even when it is highly deceptive, and perhaps even illegal, to do so. This is ironic when their own code of ethics reads: (2.4) MMHA members seek to be aware of personal bias, such as religious or ideological views, which could interfere in allowing clients to explore freely within a therapeutic process.

Obviously, it would behoove them to follow their own stated guideline.

And here's the real kicker: being Mormon is not even one of the requirements of becoming listed in the directory of the Mormon Mental Health Association, nor is there any requirement to clarify one's connection to the LDS church at all. You can be Mormon, former-Mormon, never-been-Mormon, or even excommunicated-Mormon--and there is no requirement to outline your link to the church. The only thing ostensibly connecting any of these therapists to the Mormon Church is the very title of the organization itself--a very flimsy umbrella of association for a public who will be hungry to find therapist who who share their beliefs. To be clear, I have great confidence in well-trained clinicians of any religion or creed to treat LDS folks--indeed I often refer my surplus of LDS clientele to professionals who are not LDS (and always inform said clients of the religious difference so that the client can make an informed choice). What I am saying here is that I believe that to become a member of an organization called the "Mormon Mental Health Association" as a non-Mormon, and then to not clarify your status with the religion, is tantamount to false advertising. Yet the organization makes no provision that a practitioner make explicit these differences in believe.

Apparently, they're so busy making sure professionals aren't allowed to mention their documented certification as a sex addiction therapist that they can't be bothered with minor details like making sure an LDS client seeking out a Mormon therapist from the Mormon Mental Health Association is informed whether or not the therapist listed is, in fact, an actual member of the Mormon church.

In conclusion, I want to say that I really don't relish in posting this. There are people I know and very much respect who are part of the MMHA, and I don't want them to be maligned in any way because of this association. I dislike the idea of trying to tear something down instead of spending my energy elsewhere--building something I believe in. After this post, I plan to do exactly that, and let the cards (if any) fall as they may. That being said, I would feel deeply negligent if I didn't publish a post outlining what I know about this situation so that people like my friend (when searching for Mormon therapists or even Googling "Mormon Mental Health Association") can find helpful information regarding some of the more troubling details of this group instead of just assuming--as the advertising implies--that this is a legitimate group affiliated with the Mormon church.

All right. Enough serious talk for me for one day. Time to go play with my kids.

Below is the letter I sent to the board:

Dear MMHA board,



I recently got your email with the proposed changes and direction regarding sex addiction within the MMHA community. I am sending you this email because I have some significant concerns about it that I thought you might want to be aware of. I have written the following in response to the emailed proposal, but wanted to email it to the board specifically (instead of submitting it in the form) so that it can be a dialogue as opposed to a random, anonymous response.  Consider the following as if it were written in the “comment box” on the survey you sent MMHA members:
The opinion that sex addiction does not exist is not based in science. It is based on the personal biases and conclusions of individuals like the clinicians quoted in your proposal. To wit: instead of peer reviewed science backing the claims contained in your proposed statement/position, you have included nothing more than quotes from practitioners who hold the opinion that sex addiction does not exist, or could be explained through differential diagnosis. However quotes from probably-very-good clinicians do not a peer reviewed, robust scientific analysis make. For the MMHA to take such a definitive stance on this issue without proper scientific backing is very concerning and, in my opinion, verges on being unethical.

While general addiction science and treatment is well established and recognized in the psychological community, the science behind process addictions (like hyper sexuality, gambling addiction, food addiction (binge eating disorder), and internet gaming addiction) is still very nascent, as evidenced by some of the research proposed within and about the DSM-V itself. While at least one field study has already indicated that proposed criteria for hypersexuality are valid and reliable, it will be many years before our field has definitive answers regarding the diagnosis and classification of any of these disorders. And that's okay. That's how science works. Sometimes it takes time.



In one of the quotes from your proposed statement, a clinician admits that the "struggle" of hypersexuality (or at least its symptoms) "is real." That means that these symptoms are showing up in practitioners’ offices, and must be responded to. At this point, the science is so fledgling that no specific modality, treatment model or even diagnostic criteria for said "struggle" has been decided on by the broader scientific community. As such, taking a stand that bars a completely valid treatment model (addiction therapy) when there is not sufficient scientific research to justify its exclusion is jumping the gun in a big way, and in this case seems to reflect deep bias and a profound misunderstanding by MMHA of the sex positive, non-religious-based stance taken by Certified Sex Addiction Therapists, of which I am one. 



Weak, mostly anecdotal articles exist that will buttress the biases of either side of this dialogue, but there is currently a paucity of robust, peer reviewed literature on this topic in either direction.  It is important to note that a lack of robust scientific studies is not proof that sex addiction (hypersexuality) isn't real in the same way that a lack of people testifying that the sky is blue does not prove that it is purple. This is a logical fallacy called argumentum ex silentio (argument of silence) and it is a grossly negligent basis for a policy decision like the one(s) proposed by MMHA.



Inchoate science and a lack of definitive research does not preclude clinicians from treating presenting symptoms of this "real struggle" using best practice, research based modalities like cognitive behavioral therapy, motivational interviewing, and group therapy, etc, which are the bedrock of the addiction model. To claim otherwise before there is robust scientific data sufficient to back that claim is a severe overreach.



If this is the policy that MMHA adopts around this issue, not only will I no longer endorse, support, or participate in this organization, but I will feel a professional obligation to publicly discredit the non-scientific, non-research based nature of this decision. Obviously, I am only one voice, but I feel strongly that publicizing accurate information about this decision would be especially critical for the LDS community, given that the sex negative messages propagated by the LDS church arguably create a larger population than average of people who--because of negative messaging around normal developmental behaviors like masturbation, arousal, developmentally appropriate experimentation, etc.--have especially maladaptive sexual dysfunctions that call for appropriate, best-practices-based interventions (like addiction therapy, among others) to resolve.



This is not to say that addiction therapy is the only solution. Naturally, any good practitioner will rule out differential diagnoses, as the quotes in your proposed action suggest. But when those rule-outs come up empty, addictions treatment is a perfectly legitimate, scientifically sound therapeutic modality choice for the treatment of the aforementioned “struggles” of those who present with symptoms of hypersexuality while we wait for the science to further elucidate this issue. Furthermore, to conflate religiosity with professional sex addiction treatment is a blatant mischaracterization of a professional modality that is not connected to faith traditions of any kind, has a fundamental aim to reduce shame around sexual behavior, and that arguably helps thousands of people effectively respond to the deep wounds and poor sexual health caused by negative religious messaging—i.e. the kinds of wounds and poor sexual health we so often see in the Mormon community.



In reality, I feel that all practitioners within MMHA have similar goals in helping LDS people who have been hurt by the religious pathologizing that happens around sexuality in our congregations: we want our clients to rid themselves of shame, and we want them to be able to live sex positive, healthy intimate lives with their partners. Cognitive behavioral therapy, motivational interviewing, and group therapy, etc. (the essence of addictions treatment), and the sex addiction treatment model as a whole, are perfectly reasonable modalities to employ in order to achieve that aim.



I realize this is a new organization, and growing pains are inevitable. However issues like the one I address here have me questioning whether this organization, which I was thrilled by initially, can adequately represent Mormon mental health practitioners like me who are tired of the church-tethered, insular practices of former decades and wish for an organization based on sound scientific research instead of fear-based, reactive biases. (Biases, misunderstandings, and fear-based exclusions of healthy clinical models are something that the church has been plagued by for many years, so it is frustrating to see that happening here as well, in the other direction.) It makes me question this organization's perception of science, its assessment of what constitutes best practices, and its ability to participate responsibly in cutting edge social activism that would promote the mental health of Mormons. In other words, I contend, and plan to publicly point out, that if the MMHA takes this stance on sex addiction, it will fail to meet its own objective "to be up-to-date on credible, peer-reviewed, best-practice approaches to all issues surrounding mental health and serve as educators of such information.”



At the same time, I appreciate the methodical nature of your decision making process, and the opportunity you have given your members to contribute to the dialogue around this issue. I would be happy to engage in a conversation around these ideas if that were of interest to you. Thank you so much for your time.



Sincerely,



Josh Weed, LMFT, CSAT

55 comments:

  1. Thank you for posting this. I will probably be looking for a counselor to help process some serious crap that has happened in my family. LDS Social Services may or may not be a good fit. A LDS counselor would be best because they know my standards along with various other things.

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  2. https://www.lds.org/legal/terms?lang=eng&_r=1

    Trademarks

    “The Church of Jesus Christ of Latter-day Saints,” “Liahona,” “Book of Mormon,” and “Mormon” are trademarks of Intellectual Reserve, Inc.

    E-mail: cor-intellectualproperty@ldschurch.org

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    1. Yah. The lds church owns the name "Mormon". They are in trademark violation. The church is cracking down on these type of things. I'd just send them this information and let the church lawyers take care of them so they at least change the name.

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  3. My husband has been dealing with a porn addiction since he got home from his mission 10 years ago. He came clean before we had kids and worked on it. I found him "acting out" about 3 years ago. He said he never even tried. Recently he tried to stop and really wanted to but with a lot of family stress has gone back. There are days where I can look at it as an addiction and not take it personally. Other days I really struggle. To learn this organization wants to exclude this area and pretend sex addiction doesn't exist is tough. Like the pain my hubby and o have suffered over and over again is for nothing.

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  4. Thank you for your efforts to educate those of us who didn't know. This is a horrible situation and I truly appreciate your efforts to inform us.

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  5. Thank you for taking a stand.

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  6. Many Mormons are becoming educated on their own in regards to sexual addiction. Fight the New Drug spoke at my stake building last year. It was wonderful. I don't care if this organization believes sexual addiction is not a real addiction. They can be left behind in regards to science if they choose. What I care about is that they are branding themselves "Mormon." All the Mormons I associate with believe sexual addiction is REAL and even more powerful than many drugs. How can we put a stop to this organization using "Mormon" in their title?

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  7. Love all your posts! But this one really hit home. I have friends who have struggled with different issues surrounding sexual behaviors. Thank you for standing up for them!

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  8. I found this situation concerning, so I went to the MMHA website and read their position statement. I found their explanation to have much validity. They also clearly state that their organization is for anyone interested in, or serving the LDS community. Cultural competence is always a welcome skill. As a past consumer of mental health services, my impression was that the use of the word 'addiction' is their concern because 'sex addiction' or 'porn addiction' is not a diagnosis in the DSM-V. It seemed to me their approach is to find an underlying mental health issue that is driving unwanted sexual behaviors or compulsions. As a lay person I have always found terms like 'food addiction' or 'exercise addiction' very confusing even though I know both can lead to death. I find good points in your concerns and theirs. I'm glad we have organizations like them and voices like yours. It means people care. Oh, and AMCAP (Association of Mormon Counselors and Psychotherapists) uses the word 'Mormon' in their title and they have not had trademark violation problems, so I doubt MMHA will either.

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    1. My thoughts are very similar to yours. I read the MMHpolicy statement and it is much more nuanced and balanced this article gives it credit for.
      While I appreciate and can sympathize with the examples given in the article and other commenter'sexperiences, I can also share personally that the namingand treating of this as an addiction is very damaging as wellto some.There are two sides to the story.not until I discardedthe addiction termwas I able to drop the shame and enter recovery
      It would seem that both sides are guilty of confirmation bias, although in my opinion the MMHA gives a bit more nuanced perspective with recognition that Science is still working through the issue. This article and most of the fight the new drug type stances are very keen on looking at and sharing only information that supports their biased opinion.

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    2. I am a clinician, and I feel the position you take here is an accurate reflection of the concerns held by the MMHA.

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  9. I think part of the issue is that Mormons seem to label almost every form of sexuality except husband wife penis in vagina sex as an addiction. For example, gay men who are not allowed to be in a relationship with another man and must repress and repress will almosy certainly turn to porn as an outlet. Then that gets labelled addiction along with the.shame etc. The more Mormons obsess about what sex is allowed, the more so called addiction there will be. Hence why utah has such a high rate of porn watching. Sex Addiction is a symptom of mental health issues and often of extremely rigid roles assigned in some religions. Ironically, that is what helps to keep you in business. The root needs to.be dealt with.and the heaping of shame on anyone who masturbates, for example. does as well.

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    1. To further explain my point - I realize that it may seem off topic a bit. I absolutely agree that sex addiction is real, as is alcohol addiction, gambling addiction, etc. And this addiction can ruin marriages and end lives, absolutely.
      However, what it appears the Mormon Church (and other religions with strongly defined gender roles and strict rules around sexuality) has done is helped to create the problem as I mentioned above. If shame upon shame is heaped upon those who view pornography then it is much more likely to be a hidden thing and to perhaps become an addiction. It is the same with masturbation - tell 15 year old boys it is a huge sin, they will still do it but they will do it with great great shame and suffer hugely psychologically. And then they will need therapists, It there was less shame heaped upon these men and women and less huge guilt heaped upon them about what horrifying sins they are committing, there would be less so called addiction.
      I read the organization's stance - they seem to be wanting to look at the root of behaviours such as huge shame over looking at porn, masturbation, etc, rather than labelllng those issues as addictions and never dealing with why the shame.
      Sorry I am going on here. I can tell that you really really want to help your clients and that you have a huge heart for them. But it feels a bit like you are missing the point of what that organization is saying - seems to me they are saying stop calling all porn watching addiction - it is not always addiction and it is not always harmful - it can be a natural manifestation of a repressive religion.
      - Lstrm

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    2. If someone is a well trained CSAT who stays current, they are able to identify the difference between acting out because of varying reasons, and what has crossed over into harmful, uncontrollable addiction. The Mormons do not have the market cornered on shame. It can be an issue in any strong culture or religion that is sometimes misinterpreted or taken to extremes by its members. My husband is a CSAT (I would say the vast majority of csat's are not utahn's and not Mormons). They have found that some people struggling with their sexual identity come in looking like an addiction because of their behaviors, but since they are well trained can recognize that's not the underlying issue. They have started running groups for people to help them explore, then face, and deal with their sexual identity and it becomes clear that the problem is not a sex addiction. That being said, there are many people who legitimately suffer with sex addiction and require specialized help to overcome their addiction, which includes looking at shame from family of origin, religion, school, whatever it may be, and get back to a place of self esteem and positive sexual health. I think it would be extremely minimizing to tell a family dealing with this researched and very REAL addiction that they just need to relax and not make a big deal about it. If you wanted you could look up some Patrick carnes books and see why it's a big deal and why it's not about those who
      "masterbate" sometimes. It's not a Mormon made up problem, in fact sometimes Mormons don't want to look at it.

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    3. My writing is unclear I think. My bad on that!
      I don't believe that sex addiction is a 'Mormon made up problem.' Not at all. I indicated that I know that sex addiction does exist and that it can be devastating.
      I'm pleased that there are groups/counselling that is helping some folks to realize they don't have an addiction and are instead getting to the root of the issue.
      My comments come partly from having watched some videos of some Mormon men who are gay, married to women, and call their watching of gay porn an addiction. I would argue there that watching gay porn is an (unfortunate) natural result of having to repress and repress and repress their sexuality (even while being able to be open and honest about it_). They then are told their watching porn is an addiction and they treat it as such - when in fact, the porn is a symptom of the root of the issue, if that makes sense.
      I do think that Mormons on the whole appear (and I am willing to be wrong here!)rather focused on sexuality - what is permissible, what is not, the marriage of gay men to straight women being a viable solution without much though of long term psychological effects, etc. etc. I have also seen/heard/read young Mormon folks being devastated by their masturbation 'addiction', etc. This occurs as I stated in other religions with a strong and rigid emphasis on 'appropriate' sexuality, so no, not just in Mormonism.
      i do think that the strong emphasis on sexuality and what is okay and what is not in Mormonism - makes Mormons rife for 'sex addiction' which in fact in many cases are not addictions. Some are, of course.
      Hope this is clearer or at least less muddy.
      There is apparently a bizarre and almost surreal underground sex scene in Japan - really wacky and at times disturbing things. It has been postulated that this comes partly as a result of the repression required by the Japanese as it is very very important in that culture to not stick out, as it were. I wonder if differences were allowed more out in the open, if the oddness under the surface wouldn't exist to such a degree. Ditto Mormonism, to a different extent - teach people that all but one model of sexual expression is acceptable and that all else is shameful - and 'addictions' will be all over the place.
      I think it is good that Josh is working with folks to help them to see the difference.
      - Karen

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    4. There is definitely need for more education and understanding for the population at large, I just especially wanted to clarify that indeed well trained CSAT's are trained to identify and treat addiction appropriately

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    5. Amen.
      The church's insistence that an individual is either purely Chaste or entirely addicted with no room for nuance or degrees is probably the reason that the addiction model breaks down in a Mormon context. There is no doubt that there are some Mormons that have severe "hypersexuality" that harms them and with those they love. Those people certainly need help. But lumping them in with a teenager who might look at porn occasionally is a severe disservice to the teenager.
      We have lay untrained ministry diagnosing and patients self diagnosing based upon what they hear in conference. The term addiction is loosely thrown around. And there are kids and adults and families and spouses impacted by the induced shame. Those who were damaged by the labeling understandably pushback against it.

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    6. //"The church's insistence that an individual is either purely Chaste or entirely addicted with no room for nuance..."//

      This is an extremely uninformed statement. And it certainly suffers , at best, from not having any basis in actual science or data. It's a problem I see with clinicians who assume their clientele is representative of a group as a whole. It is the very definition of selection bias (which is an extremely poor way to conduct science or make generalizations).

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    7. The church is quite black and white on the issue of sexuality, one must be in a straight marriage or one must be chaste and also not masturbate, etc. This may affect individuals differently but the actual belief is black and white.

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  10. Integrity wins again. Thanks, Josh, for always being the person to stand up for what you believe. (And back it up with great insights, experiences, and even scientific studies.) You are pretty awesome.

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  11. Hi Josh! Love your writing. Had to just point out the irony in the MMHA not legitimizing porn/sex addiction as ADDICTION. The LDS ARP program specifically targets assisting people with sex addiction, using a 12step model, and encouraging personal counseling as well. This is in the churches official ARP manuals. And MANY people find both healing, and God in that program. No matter what underlying stressors or events or curiosities,... caused the initial exposure and experimentation, once addiction sets in, it has a life of its own, physically and neurologically. President Holland spoke at UCAP (utah coalition against pornography)last week, referencing the brain research you also referenced. President Holland not only called it an addiction, he called the prevalence of it a public health crisis. http://utahcoalition.org/elder-jeffrey-r-holland-the-plague-of-pornography/

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    1. From my personal experience with ARP, not a single person there was actually addicted. They had been diagnosed by themselves or by a lay leader who has no clinical experience. The facilitators likewise have no experience. Nothing like the blind leading the blind to make things worse. The article above rails against non-experienced people giving counseling I found it much more harmful than helpful. It probably has it ever crossed your mind, but maybe the church is wrong in this regard

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    2. Just wanted to add my own experience with ARP. In mine, the majority attending most definitely WERE labeled addicted (appropriately so) by clinical psychologists (non-lds & PhDs, not LCSWs). I don't know if your experience was just in meetings focusing on porn-use. I have never been to one of those. But, in the meetings I attended, trust me, these were REAL addicts. Many participants had spent time in prison. And, many were attending as part of court-ordered rehabilitation programs--where the legal system had declared them addicts as well. When someone tells you they're addicted to meth--trust me, you don't need to question them. I also saw very real and lasting change. People with 15+ years sobriety after years of cocaine addiction. I saw an anorexic woman who'd been anorexic for 18 years, began attending at 87 lbs--and after 7 years of attending, she had had 6 years of maintaining a healthy body. The ARP program does not discourage people from getting outside counseling at all. Nor does it require people to label themselves as addicts. What it DOES do, is help people who are suffering under the burden of mistaken beliefs about themselves and God, and have turned to a substance, behavior or compulsion to deal with pain. It helps people connect with the love of God, so He can lead them to answers--whatever their answers may be. In some cases, that's "Hey this doesn't need to be called an addiction ..". In other cases, it may be something else. But, the important thing is that they come to know that they are NOT defective, or unloved by God. This video gives an example of the type of people I met in this program: https://www.lds.org/media-library/video/2012-12-013-lds-addiction-recovery-program-meet-mark?lang=eng

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  12. Hi Josh! Love your writing. Had to just point out the irony in the MMHA not legitimizing porn/sex addiction as ADDICTION. The LDS ARP program specifically targets assisting people with sex addiction, using a 12step model, and encouraging personal counseling as well. This is in the churches official ARP manuals. And MANY people find both healing, and God in that program. No matter what underlying stressors or events or curiosities,... caused the initial exposure and experimentation, once addiction sets in, it has a life of its own, physically and neurologically. President Holland spoke at UCAP (utah coalition against pornography)last week, referencing the brain research you also referenced. President Holland not only called it an addiction, he called the prevalence of it a public health crisis. http://utahcoalition.org/elder-jeffrey-r-holland-the-plague-of-pornography/

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    1. I suggest that there are such high rates of pornography viewing in Utah at least partly because of the idea that anything other than married penis in vagina sex is demonized as i stated in an earlier commment. So folks repress and feel shame and a natural outlet is porn, which could become compulsive. Then it is labelled an addiction. I would almost go so far as to say that religions with rigid gender roles and strict rules around sexuality help to create excessive porn watching. Then it gets labelled an addiction. And again some folks do meet the addiction label criteria but i suspect not nearly as many as are labelled as such. Not labelling people as sex addicts or porn addicts isn't making a moral statement that those things are "right".

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    2. This is an extremely uninformed statement based on a single study sample that was extremely biased and unrepresentative. Additional research on broader measures of pornography access (to the extent the data is even available--it's hard to come by, especially in any descriptive sense relating to break-downs along religious affiliation or non-affiliation) have made clear it is not a "Utah problem," with Utah actually ranking quite low on the list of states in regards to per capita accessing of pornography sites, even after adjusting for possible confounding factors, something the first "study" never bothered to do (never mind its small, unrepresentative sample). It was simply poor science that the non- (and especially anti-) LDS community spread like wildfire as if it were somehow a valid scientific verdict on the issue.

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    3. Regardless of whether or not Utah has the highest rate, my point about the overuse of labelling sex/porn addictions stands.

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  13. While the LDS Church has trademarked the term "Mormon," my understanding is that they have been unsuccessful in enforcing that trademark because it is a generic term with an almost 200-year history and encompasses a movement and category of people much broader than the Church of Jesus Christ of Latter-day Saints and its official members. As long as they are clear that they are not representing or affiliated with the LDS Church, they shouldn't have a problem.

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    1. The Church has actually been defending the trademark (as they must), and there was a recent case against the MMHA, which was apparently settled out of court, with undisclosed results.

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    2. The "Church" defending the trademark "Mormon" seems strange to me with as many other groups that there are that identify as mormon. Just because the LDS church is the largest of these should give them no more right to exclusive use of the name than if the Catholic church were to claim exclusive rights to the word "Christian" simply because they felt they were the largest in that category.

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    3. Didn't know they had sued MMHA over the use of Mormon. Maybe it resulted in MMHA agreeing to clarify their use of the word Mormon? They have this on their website: "The Mormon Mental Health Association (MMHA) is a professional association for mental health providers, clinicians, educators and advocates who are interested in or are working with the Mormon population. By Mormon population we refer to the membership of the Church of Jesus Christ of Latter-day Saints, as well as members of any church tracing back to the restoration movement of Joseph Smith."

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  14. Wow Josh, I think maybe you could start your own association for CSATs that emphasizes and LDS background. I think a lot of people could really benefit from this.

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    2. I agree, Lex-a-roo. I hope Josh does it.

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  15. Reading this made me sad. It also opened up my eyes and I am glad for that. I am also a member of the church, and the fact that the leaders of this group are doing this to people because of their bias is astonishing and is not what we are taught...we are taught to love people as they come to us. Do the words "sex addiction" sound scary to a lot of people? Yeah, because it makes people feel uncomfortable, but that doesn't mean it isn't a real thing for a lot of people. They should be more carung and sympathetic. These guys should be shut down.

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  16. Comment Part A

    I came across this article at random and am unfamiliar with the MMHA, having only learned of the acronym while reading your article. I am a Mormon. I am a patient, not a clinician. Granted, my only experience has been as a patient of a licensed (PhD) psychologist, and not a social worker like yourself (the term 'psychotherapist' or 'therapist' does not require a specific degree, and an LMFT license does not required a PhD degree, obviously).



    I agree with your concern about an organization calling itself 'Mormon' and not requiring its members to be affiliated with the church whose name it is using. This is unquestionably misleading. For this reason alone I have no interest in defending the MMHA.



    But, based on my experience as a patient, I disagree with your argument. For years I struggled with the use of pornography. It wasn't a daily thing. But I would usually end up on my computer looking at pornographic images or videos at least once a week. Sometimes I'd make it 2 or 3 weeks without viewing pornography, but that was more rare. As you described, this habit brought on great shame. But here is where I disagree with you. It wasn't UNTIL my psychologist and Bishop stopped defining my viewing of pornography as an 'addiction' that I finally believed I could overcome it, through the atonement (since we're introducing religion to the equation by using the term Mormon). This was in no way a sudden "denial" on my part, or on the part of my licensed psychologist or my Bishop. On the contrary, I recognized my behavior needed to change. And not labeling it as an 'addiction' helped me have more hope. Becoming free from the pull of pornography no longer appeared as great an Everest as it had when the term 'addiction' was applied to it. With the help of an amazing Bishop and psychologist, I am now able to live my life without capitulating to pornography. And NEVER at any time during the process of resolving this issue was my wife blamed for my pornography viewing, or called ... what was the term you used? ... "repressed or prudish". The issue was mine, not hers, and I owned it.

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    1. Well your case is extremely rare and I wonder if it was an actual addiction. Addiction means you don't have the same control as a non addicted person and it almost always requires professional help. Bishops can be great support but they never should replace a licensed, educated professional Mormon or not. Those people who try as they may to do "all the right spiritual" things and pray their way out of an addiction feel like an unworthy unlovable failure because they can't do it on their own and that is an extremely damaging message. I'm glad that your response didn't generalize because I hope you don't think that can work for everyone

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    2. I don't think we know that it is extremely rare. Labelling something not as an addiction doesn't then mean the only solution is to try to pray it away. It may mean freedom because the roots of the issue are more closely examined.

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    1. Taking away the term addict to many would have the opposite effect it had for you. It would give them the message they have complete control over their actions and they are too weak or too wicked to control them. If we want to get scriptural this reminds me of the versus that say Satan leads us with a flaxen cord and then binds us with his strong cords forever. I don't believe the church warns against pornography so constantly because the images will just make our brains icky but it will be totally doable to get over it on our own. I think they warn us because the initial flaxen cord will turn into strong ropes we could never untie on our own which is completely what addiction is. Our brain literally loses the typical functioning and thought processes of a non addicted brain and we cannot stop with out A Lot of therapy and focus and dedication and support and facing DENIAL

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  18. This mirrors my experience with the MMHA as well. I am an LCSW and a CSAT-S. I paid to attend the first annual conference held in SLC. I also paid for two other therapists with my company to attend as they are LDS as well. Initially the one day conference was going well as discussions were had about the purpose of the organization, the goals etc. It was repeatedly stated that one of the goals was not to exclude quality professionals from participating. Then at the end, the discussion turned to sex/pornography addiction. Many professionals agreed clients with these symptoms were showing up in their offices. Many expressed concerns about the number of professionals, especially along the Wasatch Front, who claim to be able to treat this population dealing with this behavior addiction, who actually do more harm to their clients than good. Sometimes labeling one as an addict when in fact, they are not. Me and my colleagues talked about being CSATs and the quality training we receive in order to treat this issue. We were also told we would need to have a one on one interview with the founder of this organization....which never happened. About a week later I got a survey from survey monkey from MMHA. It was heavily weighted with questions/concerns about sex addiction and those treating it being allowed to participate with MMHA. I got this survey, however, my colleagues never did. Because I took the survey. For the most part, the same concerns were raised. Professionals treating this addiction who really hadn't gotten any proper training to do so and doing more harm than good. I was then told due to my being a CSAT I could not participate in this organization and never heard from them again, they did keep the money I had paid for all 3 of us to have an "annual membership" with the organization even though we were kicked out within a month. I did get one email inviting me to renew that annual membership a year later.

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  19. Bryan,

    I think you raise good points. I especially appreciated the insight into the idea that removing the term "addiction" from your experience was freeing for you. That being said, you lost me with your attacks, assumptions, and condescension. Repeatedly belittling Josh's credentials by comparing his opinions to that of someone with a PhD does not strengthen your argument in my opinion; it only made me question what YOUR "axe to grind" is rather than Josh's. It's insulting and I don't think necessarily accurate to assume that because someone has a PhD in psychology they have more insight into the idea of sex addiction than someone who has been devoted to specialized training in that very subject. Having a higher degree of education in a broad sense does not make that person the expert in all subjects, and I doubt your "licensed (PhD) psychologist" would claim this to be the case either.

    I also found your assumption that Josh would completely discount your entire experience because "[he's] the social worker, while [you're] not" (which I believe was another attempt to jab at Josh's credentials) is fallacious and damages your credibility. In the original post, Josh used the experiences of friends, clients, and loved ones to legitimize his thoughts on the subject - what would make you assume he would turn around and discredit experiences that differ? It contradicts the entire tone of his message and doesn't make sense to me, as personal experience is at the heart of his message.

    I was especially bothered by your admonition, "But don't attack others who don't agree with you..." since your own response was rife with attacks, and based on this interaction it would appear you're not practicing what you're preaching. While it's likely you don't care much about my opinion, I thought I'd share how your argument came across to me (and likely others) so perhaps you may consider other methods to present an opposing argument, so you may more successfully hit your intended result.

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  20. Josh, thanks for taking a stand and clearly communicating your thoughts on the subject while giving a voice to others who may find themselves mislead or damaged by the position this organization is taking.

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  21. "Yet the organization makes no provision that a practitioner make explicit these differences in believe." <-- belief

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    1. Thanks for adding so much to the discussion

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  22. Josh, your opinion piece here would be credible if it discussed in a balanced way the controversy surrounding the several issues you raise. The term "addiction," for instance, has been applied so broadly by people with a wide spectrum of agendas and meanings that it has lost its precision and some of its usefulness as a clinical label.

    As another example, to be balanced, people with clinically identifiable addictions have been shown to exhibit different cognitive processes than those with sexual compulsions. Instead of discussing the unsettled science, you speak of it without much equivocation.

    Another problem is the tendency for lay people to associate addiction treatment with 12 step programs. As you know, the 12-step process has very little scientific support beyond the benefits of community. Using the label "addiction" rather than an alternative without the baggage such as "compulsion" affords more power to a clinician to control the definition and direction of treatment.

    Many of the articles that have been put out in support of the concept of "sexual addiction" are not broadly accepted, and are often supported by therapists selling treatment or "educational" programs for the condition to people with religiously based, non-scientific definitions of sexual compulsion.

    Let's let the science define the compulsion and suggest the treatment instead of religion, clinical experience, anecdotes and salesmanship.

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    1. Amen. Well said

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    2. There may be more evidence for 12 step programs than you realize.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746426/

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    3. 12 step programs do indeed work. I think the issue is more that some things are being labelled as sex addiction when they are not. If something is not labelled as an addiction, it does not mean that the person won't get help. It might mean that what is being labelled as addiction by non -professionals (religious leaders for example) will be reduced.
      - Karen
      - Karen

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    4. "...to be balanced, people with clinically identifiable addictions have been shown to exhibit different cognitive processes than those with sexual compulsions." Could someone (Josh?) please explain what the difference between an addiction and a compulsion is in the first place? I've never really thought of the two as separate things. Compulsion for me means you feel compelled to do something very strongly with a feeling of lack of self-control to do otherwise. Addiction means exactly the same thing to me. Why shouldn't the two terms just be used interchangeably?

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  23. Thank you for sharing this. I agree that the using the title of "Mormon" in the name of the organization is misleading and likely a copyright violation. I also think it is unhelpful for any organization that claims affiliation with The Church Of Jesus Christ of Latter-Day Saints to repudiate the addictive nature of pornography. Treating pornography as anything less than the public health crisis it is, which would include limiting access to licensed Sexual Addition therapists, is extremely short-sighted and, I believe, a critical failure that will lead to future heartbreak and dissolution of family bonds.

    Really, thank you for sharing this. It's not always easy to stand up for what you know is right instead of "making waves". But it is critically important to do so.

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  24. I'm currently specializing in sex therapy and this very debate is one that I'm sort of agnostic on. On the one hand I've met several clients (Mormon or not) who have what feels and tastes like an addiction or an addiction in recovery. Like you watching their very real pain, the very real effects (including physiological symptoms like erectile dysfunction in their 20's), and the very real changes to mental/relational/spiritual/emotional health as their behavior and attitudes are redirected.
    That said I think are lds culture overuses the term. I've met several clients who feel they have an addiction, I talk it out, explore the parameters and then say....yeah I don't think that's what you have. Several then fight me on it. They don't want to believe their behavior is anything but terrible and nigh unto murder. We work on that, talk about it, confront some beliefs and for a number their problems magically becomes more manageable. And the porn less appealing as the feel more powerful to make sexual decisions congruent to the beliefs and working on their sexual relationships period. Some of the behaviors, particularly from several sexually abused clients mirror with addiction...but aren't and labeling it as such doesn't really help.
    In short I find this muddy. On the one hand the professional consensus, particularly groups like aasect are not fans of the terms and prefer not patholigizing sexual behaviors period. To me that feels like refusing to name a plant because all plants are essentially the same parts on the outside and will ergo taste the same. It also doesn't fit what I'm seeing and I feel larger parts of society are sending that too.
    On the other lds notions are still too black and white and some of our religious teachings do seem to make what may be problematic a lot worse. For example the women I've seen with husbands who view porn vary wildly in response. Some could care less about the porn and can basically joke about it. Others are going through severe betrayal. And it very much reflects past family concerns, their own exposure to porn, and their religious outlook/dialogue around it, as well as sexual attitudes.

    So I remain vaguely agnostic on that. I do think it's in error to take such a drastic reaponse to an issue that however you cut it is still changing our sexual culture...and not always for the better.

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  25. There is a precedent for organizations using the term LDS or Mormon, so I doubt that the church can prevent them from doing so. However I understand your point that doing so makes it look like the group has been sanctioned.

    http://eom.byu.edu/index.php/Societies_and_Organizations

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  26. So my FAML 150 class had me do a review of this site for my class as though they promoted it. I'm so glad I didn't join.

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  27. As a wife of a sex addict, I attend a therapist-facilitated support group for spouses of addicts (alcohol, marijuana, porn). Whether we call the problem with porn and sex an addiction or compulsion does not matter that much to me, but I do have a question as to why the husband's with sex addictions have the same manipulative and co-dependent type of behaviors as the other addicts (alcoholics, etc). I've been with this group for over a year and a half and have seen the same behaviors in these women's spouses as the addicts reject or are in denial about their addictions, as they get into recovery and deal with their shame and stop turning to their vices as coping mechanisms. The vices are all different, but the addict-type behavior is exactly the same. Family members (spouses, parents) of these sex/porn addicts have major co-dependency dynamics (although many spouses of porn/sex addicts seem to reject this, I would challenge that if they looked deep enough they would be able to see a very strong co-dependency dynamic).

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